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Pediatric Constraint Induced Movement Therapy
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Pediatric Constraint Induced Movement Therapy - October 24, 2004 3:47:00 PM
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VagusX
Posts: 216
Joined: March 26, 2003
From: Savannah, GA, USA
Status: offline
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I have been researching CIMT for a few weeks now. I have found a great resource at http://www.stroke-info.com/cimt.htm. The research shows some convincing evidence that CIMT is effective in improving motor function with children with hemiparesis.
I am currently working with a 5 y/o child with left UE/LE hemiparesis and left sided neglect. He has also scored high on the Childhood Autism Rating Scale (CARS) and the Gilliam Autism Rating Scale (GARS). His scores show severe autism.
Throughout our Physical Therapy treatments I have been working a lot on improving his left UE function. He uses his left occasionally, mostly when he absolutely needs his left UE during tasks such as getting up from the ground. I have been trying some makeshift restraints during our sessions and I notice an immediate improvment in the amount of left UE usage.
I am looking for anybody's input or experiences with CIMT. I would really like to talk to somebody who has done CIMT with pediatrics and more specifically on CIMT with children with learning disabilities or autism.
Thanks in advance
Dan
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Re: Pediatric Constraint Induced Movement Therapy - October 24, 2004 4:36:00 PM
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nari
Posts: 1568
Joined: November 14, 2003
From: Australia
Status: offline
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Had to answer this one...
not in my paediatric experience (which is zilch) but in stroke rehab, the restraint principle, though a bit dodgy with ethics, has worked extremely well with enhancing use of the affected side. Improvement can be quite significant over a relatively short time ( a few days).
With kids, permission from the parents is easier than with adults, whose close others are quite entitled to refuse restraint practices.
As an example, about fifteen years ago, I saw a 40-something male with total upper arm hemiplegia who had stroked out from cardiac problems and THREE years later, came to me because he had fallen over and fractured his unaffected humerus. It was confined for six weeks.
By the time it became free to move (and very stiff), his affected arm had gained function.
Some months later, he gained full function of both upper limbs.
It would seem, it is never too late...
Nari
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Re: Pediatric Constraint Induced Movement Therapy - October 25, 2004 8:27:00 AM
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VagusX
Posts: 216
Joined: March 26, 2003
From: Savannah, GA, USA
Status: offline
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This is exactly what I am seeing. As soon as I restrain his unaffected side he will start to use his affected side with very little cueing. He won't even consider using his affected side when his right (unaffected side) arm is available.
After a 1/2 hour treatment using a makeshift restraint he appeared more aware of his entire left side. It was pretty amazing.
Anybody else? Pediatric experiences?
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